Self-Management Model, which provides an evidence-based framework to help patients understand their role in chronic disease management. Classes were held at local community sites and helped to reach a vulnerable population (Lorig et al., 1999). In partnering with patients, nurses helped patients gain a better understanding of their chronic condition and improve medication adherence.

In the African American community, high blood pressure (HBP) is one of the most common chronic disease in the United States. A study led by Dr. Martha Hill, the dean of the Johns Hopkins University School of Nursing, demonstrated how a health care team led by a nurse practitioner, a community health worker and a physician consultant successfully lowered blood pressure by 44 percent as compared to control group. By lowering blood pressure, the men in the study also benefited from fewer signs of heart and kidney damage, all of which lead to lower healthcare costs. The nurse practitioner and healthcare team worked in a community setting and providing primary care interventions. An important highlight is that the health care team worked with high-risk African American males in an urban community. The multidisciplinary NP led team, ensured patients received regular health care services and established lasting, trusting relationship that led to lifestyle changes ultimately leading to improved hypertension management (Hill et al., 2003).

Nurses working in the community play a critical role in health promotion and disease prevention. A study by Dr. Loretta Sweet Jemmott, Director of the NINR Hampton-Penn Center to Reduce Health Disparities, demonstrated how black nurses working in schools, health clinics, and other primary care settings helped at risk adolescents learn the importance of using safer sex practices to reduce their exposure to HIV infection. The nurses used various evidence-based interventions designed such as audiovisual demonstrations, technical skill building demonstrations, role-playing, and discussions to engage the adolescents in protecting themselves and others in their community from HIV infection (Jemmott et al., 1998).

The Nurse-Managed Health Center (NMHC) is an evidence-based model that provides care to 2.5 million patients across the country. Services provided in NMHC include primary care, health promotion and disease prevention services to medically underserved patients living in both rural and urban areas (NNCC, 2009). They strengthen the nation’s health care safety-net by providing services regardless of a patient’s ability to pay or insurance status. Services are offered in easily accessible locations such as schools, homeless shelters, senior centers, churches and public housing developments by a wide array of health care professionals, including nurse practitioners serving as primary care providers, registered nurses, health educators, behavioral health specialists, community outreach workers and collaborating physicians. For many patients, the centers are their only option for accessible and affordable care. In addition to the incredible menu of services provided, NMHC are cost effective as demonstrated by researchers at Johns Hopkins University School of Public Health who analyzed Uniform Data



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement